Help us make Friends Life pay out Nic Hughes' critical illness policy

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

There does seem to be some agreement here

Whether FOS 'side with' the insurer or the complainant will depend entirely on the merits of the case. I don't think they would award payment on an ex-gratia basis they simply decide what is a fair outcome based on the circumstances.

As for the point about what question was asked - I have a Friends Life application here in front of me (from my own policy) and it asks 'In the last 5 years has the applicant had numbness, loss of feeling, tingling of the face or limbs or face, loss of balance or co-ordination'. It is either 'yes' or 'no'. From what we have heard reported of this case my understanding is that Nic answered 'no' when in fact he had reported symptoms to his doctor.

Some have said that it shouldn't matter/ was not relevant. Well, sorry but it is - under the current law, and under the new law that will come in in March

Some will say that Friends should pay him anyway out of compassion - they might do so but such a decision would have to be auditably fair in relation to other customers (in other words it could not be inconsistent with the way other claimants would be treated just because Nic has internet supporters).

My views on this are known, but I really see no prospect of Friends paying out on tis due to a web campaign - and those who think the publicity is or will hurt them are being very optimistic. There is no one of influence in the financial sector taking Nic's side (let's not imagine Stephen Fry is influential) and that won't change unless the family goes to FOS. If they win, there financial worries will be settled, and if they lose then maybe (just maybe) Friends may still do something for them - but I would not imagine that the current activity increases that possibility.

[MissFM]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

What about whether the mistake on the form was "reckless" or "inadvertant"?

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

An off-thread quickie for charlie505 - can you look at "almond beach" thread please? i think you might be able to help - Thanks!

Well, I'm obviously useless at navigating this site - I can't find this Almond Beach thingy, Miss FM. (The search has been an education in other respects though!)

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

What about whether the mistake on the form was "reckless" or "inadvertant"?

Well that does make a difference under the new law (clear cut if it was 'reckless' non disclosure, but if 'inadvertent' non disclosure it would depend substantially on whether Friends would not have entered the contract on those terms had they known the truth). Under the present law the requirement to disclose anything that would reasonably be considered to be material places more of an onus on the customer. Intuitively, although the new law isn't in force yet I suspect it would still be a key consideration for FOS -although they are not bound to follow the law in deciding what is fair.

By the way - an earlier post referred to the backlog at FOS (mainly PPI complaints) but I think these are handled separately. In any event I think Friends would probably ask Natalie Ceeney to make sure this case got quick attention.

[MissFM]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Well, they (FL) have said that, so let's hope it's true and that the family is advised to do it now.

The thread (and funnily enough I had trouble finding it again) is under "general consumer issues", entitled "insurance claims" and the poster "almond beach". I found it by clicking on "advanced search" and putting "almond beach" on the posters thingy - just think you could help with an odd and seemingly dishonest insurance prob.

[Inca]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

FL policies may well say that NOW,but did the policy Nic signed have that inclusion.Plus,,the symptoms they list are a bit innocuos..Most people have had the tingles in the last 5 years I should think,,try sitting on your foot for a long time,,bet ya can't walk for 5 mins after.
Very vague question,,open to interpretation....so far FL 0---Inca 1...........still stinks

[TUTTSI]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Charlie can you please look at this link - you maybe able to give an answer http://www.legalbeagles.info/forums/...e-Claim-Issues it is on an insurance claim issue for property.

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Tuttsi - have responded to the thread - property isn't my area - but will get an expert view and come back on it next week

[MissFM]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

[QUOTE=TUTTSI;308195]As I have seen many times the FOS have a huge backlog and waiting time to deal with claims. They are supposed to be impartial, but I have seen incidences where they they side with the insurer.

There is something wrong with this sentence Tuttsi - impartiality could mean them finding for either side according to perceived merit.

[TUTTSI]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

That sentence reads fine to me lol.

A friend of mine is in a huge battle with the FOS at this time on a simple matter which they have misunderstood and then they incorrectly sided with the insurer. Hopefully she is getting this overturned, maybe my grammer may not be spot on but the essence of what I am saying is correct + I have known other cases in the past where the FOS and other type of mediators just side with the companies rather than make an award to the person complaining. There has been a few on here with PPI that I have read that have not been sucessful with the FOS. I am just very warry of this type of mediation. Impartial they are supposed to be - but I am not so sure TBVH.

[QUOTE=MissFM;308475]

As I have seen many times the FOS have a huge backlog and waiting time to deal with claims. They are supposed to be impartial, but I have seen incidences where they they side with the insurer.

There is something wrong with this sentence Tuttsi - impartiality could mean them finding for either side according to perceived merit.

[MissFM]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Nothing to do with your grammar Tuttsi which is surely better than mine - just the implication that it must be somehow wrong to find for the insurers - maybe they are sometimes correct? Mediation must allow for the possibility of either side being mistaken? Otherwise it is not mediation.

[Inca]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

I see this as simple....FL are trying to bail out of paying cos they can......Nics not here to ask'did you mislead them'?
If the insured person has already passed away the question becomes unanswerable so they should and could have paid out. End of story.

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Inca
I think we may have covered this earlier in the thread - but the form I am quoting from is roughly the same vintage as the one Nic will have completed (granted though, it may not be exactly the same). The point about innocuous symptoms is actually straightforward - it isn't trivial if you thought it important enough to consult your doctor about it. And as far as Nic not being here to answer questions - he was still alive when he started campaigning, but a plaintiff who is deceased is something the law has to deal with all the time anyway.

We aren't going to agree on the Nic Hughes case Inca. If you think 'it stinks' then I respect your opinion - but I don't think that moves us forward. At some point the Nic Hughes case will conclude but the broader issue remains and I think it is this:

Regardless of what the law says – is there generally a case to be made for insurers to take a different approach to non-disclosure on application forms – and what specifically should that approach be? That is the question I would like to ask to those interested in this discussion – and it might be worth starting a new thread on it.
To elaborate on this a bit...
If someone omits a material fact or tells an untruth – should the insurer always ignore that and pay up anyway? If so - would you be prepared to pay higher insurance premiums to cover that approach?
If not - what process or criteria would you use to separate the honest mistakes from the deliberate liars (or would you allow both?) How could you ensure that this would apply consistently and fairly to all customers? What should the appeal process be?
There is a lot of interesting stuff underlying this case – and would be good to get some thoughts on whether/how there could be reform of current practice.

[Charlie505]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Tuttsi

I have spent time with the key people at FOS, and whilst I don't agree with them on everything, they do try to be as impartial as possible - sometimes insurers are frustrated about a decision and consider it wrong, and sometimes it will be the person complaining who will think that. That would be the same if you went to a court of law - except that it would be expensive and take a lot longer to get a decision. FOS are a big operation (particularly because of the deluge of PPI cases) but they are no friend of the insurance industry - and if on occasions they uphold the insurers view on a case it will be as a result of a considered appraisal of the situation.

[Inca]

Re: Help us make Friends Life pay out Nic Hughes' critical illness policy

Now that I totally agree with you on Charlie,and I hope,because of Nic,the insurance world becomes a lot more vigilant and open.There are way too many 'loopholes'.I'd have to think long and hard about what I say hence I won't prattle on just now.
I will keep my fingers crossed that the FOS see sense and make FL pay up.